Organization
SPORT & SPINE REHAB OF COLUMBIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY S GREENSTEIN DC (CEO)
(410) 964-0837
Entity
Organization
Contact information
Practice address
10760 HICKORY RIDGE ROAD, 119, COLUMBIA, MD 21044
(410) 964-0837
Mailing address
11418 LIVINGSTON ROAD, FT. WASHINGTON, MD 20744
(410) 964-0837
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200064
CIGNA PPO
—
01
—
200289
ASHN CIGNA HMO
—
01
—
2103322
OPTIMUM CHOICE
—
01
—
3348462
AETNA HMO
—
01
—
4535854
AETNA PPO
—
01
—
G921
BCBS OF NCA
—
01
—
KEG7SP
BCBS OF MD
—
Enumeration date
05/04/2007
Last updated
04/20/2008
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